Mobile Exam Center Interview and Exam

National Health and Nutrition Examination Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0950 can be found here:

Documents and Forms

Document Name Document Type
Mobile Exam Center Interview and Exam Form
MEC Questionnaire and Exam Att_3f_MEC Questionnaire Exam 081718.docx Form
MEC Questionnaire and Exam Att_3f_MEC Questionnaire Exam 081718.docx Form
Att_3g_MEC-CAPI DRQ_ Hand Cards 072718.docx MEC Hand Cards IC Document
Att_3g_MEC-CAPI DRQ_ Hand Cards 072718.docx MEC Hand Cards IC Document

Information Collection (IC) Details

IC Title:	Mobile Exam Center Interview and Exam	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	MEC Questionnaire and Exam	Att_3f_MEC Questionnaire Exam 081718.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Health and Demographic Surveys Conducted in Probablity Samples of the US Population	FR Citation: 49 FR 37693

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-5,000	5,000
Annual IC Time Burden (Hours)	-20,000	20,000
Annual IC Cost Burden (Dollars)	-477,200	477,200

Documents for IC

Title	Document	Date Uploaded
MEC Hand Cards	Att_3g_MEC-CAPI DRQ_ Hand Cards 072718.docx	09/13/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.